| Regimental number | 2011 |
| Place of birth | Port Melbourne Victoria |
| Religion | Church of England |
| Occupation | Dairyman |
| Address | Dixie via Terang, Victoria |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs Edith Raymond, Petersham, Sydney, New South Wales |
| Enlistment date | 9 March 1916 |
| Rank on enlistment | Private |
| Unit name | 58th Battalion, 3rd Reinforcement |
| AWM Embarkation Roll number | 23/75/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A31 Ajana on 8 July 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 58th Battalion |
| Fate | Returned to Australia 20 June 1918 |
